How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $467.74 Median $1,862.09 Typical High $4,073.80 | Facility | None | $467.74 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $537.03 | Professional | None | $407.38 | $467.74 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $2,089.30 | Professional | None | $416.87 | $512.86 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $1,318.26 | Professional | None | $389.05 | $457.09 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $870.96 Typical High $1,096.48 | Professional | None | $478.63 | $870.96 | $1,096.48 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $1,318.26 | Professional | None | $309.03 | $588.84 | $1,318.26 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $79.43 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $331.13 | $331.13 |
Where Washington, DC sits
The same service costs 6.5 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Washington, DC· 33rd of 51
$513
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.